You Be tthe Coder:
Don't Bill D&C, Endometrial Ablation Together
Published on Tue Nov 24, 2009
Question: My doctor did a diagnostic laparoscopy (49320), a hysteroscopy (58555), a dilation and curettage (58120), and a NovaSure with endometrial ablation (58563). What codes I can bill for this date of service? Connecticut Subscriber Answer: First of all, you must have a medical indication for the diagnostic laparoscopy (49320, Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen[s] by brushing or washings [separate procedure]). Some physicians are now doing the laparoscopy to ensure they do not puncture the uterus during the hysteroscopic procedure. If that's the reason, most payers will not reimburse it. Second, you have an all inclusive code that includes hysteroscopy with a dilation and curettage (D&C): 58558 (Hysteroscopy, surgical; with sampling [biopsy] of endometrium and/or polypectomy, with or without D&C). Notice the phrase "with or without D&C." Warning: Trying to bill separately for the hysteroscopy as 58555 (Hysteroscopy, diagnostic [separate procedure]) and the [...]
